MEDICARE: MS. ELLEN L. SHULMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	003188-1	NY

General Provider Information

NPI Number	:	1326341686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELLEN L. SHULMAN

Provider Business Mailing Address
First Line	:	317 RHINECLIFF DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-1620
Country	:	US
Telephone Number	:	585-244-7514
Fax Number	:	585-271-4221

Provider Business Practice Location Address
First Line	:	194 FIELD ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-1942
Country	:	US
Telephone Number	:	585-271-4583
Fax Number	:	585-473-7131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	12/08/2010

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Directions to “ MS. ELLEN L. SHULMAN ” Practice Location

Language	Start Address	Practice Location

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